CRC: IV 5-FU tops capecitabine for response rate, safety

  • Wu Z & al.
  • Curr Treat Options Oncol
  • 27 Nov 2018

  • curated by Jim Kling
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In patients with metastatic or advanced colorectal cancer (CRC), continuous intravenous (cIV) 5-fluorouracil (5-FU) is associated with better response rates and fewer adverse events than capecitabine.
  • Survival outcomes were similar. 

Why this matters

  • This is the first meta-analysis to specifically examine capecitabine and cIV 5FU, which are the most commonly used fluorouracil modalities.

Study design

  • Meta-analysis of 23 studies (n=10,105).
  • Funding: National Natural Science Foundation of China; Fundamental Research Funds for the Central Universities, Baxter (China).

Key results

  • The response rate was lower in the capecitabine-based regimen (n=3786; relative risk [RR], 0.9; P=.01).
    • Effect was significant when regimens were combined with oxaliplatin (RR, 0.90; P=.04), but not when combined with irinotecan (RR, 0.91; P=.13).
  • There was no significant difference in PFS, time to treatment failure, OS, or DFS.
  • Capecitabine was associated with more grade 3/4 AEs:      
    • Diarrhea: RR, 1.68 (P<.001 irinotecan: rr>
    • Vomiting: RR, 1.30 (P=.006); with irinotecan: RR, 1.87.
    • Nausea: RR, 1.34 (P<.001 irinotecan: rr>
    • Hand-foot syndrome: RR, 5.46; P<.001.>
    • Thrombocytopenia: RR, 1.62; P=.02;
    • Dehydration: RR, 2.33 (P<.001 irinotecan: rr>
  • cIV 5-FU was associated with more grade 3/4 neutropenia (RR, 0.34; P<.001 and stomatitis p=".01).</li">

Limitations

  • Treatment regimen heterogeneity.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit